healthslips.com.au Policy Information

GMHBA Limited

GMHBA Silver Plus Premium Family Package (No Pregnancy) $500

$738.20 / month

(Before Rebate, Discount & Loading)

Available in NT

You may be entitled to an Australian Government Rebate on the above premium. Your premium may also include a Lifetime Health Cover Loading, an Age-based Discount or an insurer discount. Check with your insurer for details.

This policy covers: Two adults (and no-one else).

Policy ID: GMH/J72B/DIID20

Source: Private Health Information Statement (PHIS)

Hospital Cover

  • This policy exempts you from the Medicare Levy Surcharge.
  • This policy does not provide accident cover.
  • This policy does not provide benefits for travel or accommodation outside of hospital.
Covered
Restricted Cover
Not Covered
This policy includes cover for
Back, neck and spine
Blood
Bone, joint and muscle
Brain and nervous system
Breast surgery (medically necessary)
Cataracts
Chemotherapy, radiotherapy and immunotherapy for cancer
Dental surgery
Diabetes management (excluding insulin pumps)
Dialysis for chronic kidney failure
Digestive system
Ear, nose and throat
Eye (not cataracts)
Gastrointestinal endoscopy
Gynaecology
Heart and vascular system
Hernia and appendix
Hospital psychiatric services
Implantation of hearing devices
Insulin pumps
Joint reconstructions
Joint replacements
Kidney and bladder
Lung and chest
Male reproductive system
Miscarriage and termination of pregnancy
Pain management
Pain management with device
Palliative care
Plastic and reconstructive surgery (medically necessary)
Podiatric surgery (provided by a registered podiatric surgeon)
Rehabilitation
Skin
Sleep studies
Tonsils, adenoids and grommets
Weight loss surgery

This policy does not include cover for

Assisted reproductive services
Pregnancy and birth

The benefits paid for hospital treatment will depend on the type of cover you purchase and whether your fund has an agreement in place with the hospital in which you are treated. See ‘Agreement Hospitals’ on privatehealth.gov.au for which hospitals have arrangements with your insurer – https://privatehealth.gov.au/dynamic/agreementhospitals.

Under this policy, you may have to pay out-of-pocket costs above what you get from Medicare or your private health insurer. Before you go to hospital, you should ask your doctors, hospital and health insurer about any out-of-pocket costs that may apply to you.

The following payments may also apply for hospital admissions

Excess: You will have to pay an excess of $500 per admission. This is limited to a maximum of $500 per person and $1000 per policy per year.

Co-payments: No co-payments

The following waiting periods for hospital admissions apply to new or upgrading members

Waiting periods:

  • 2 months for palliative care, rehabilitation and hospital psychiatric treatments, even if pre-existing
  • 12 months for other pre-existing conditions
  • 2 months for all other treatments

Gap Cover

This provider offers 'known gap' or 'no gap' cover for medical bills for this product. The Medical Costs Finder (https://www.health.gov.au/resources/apps-and-tools/medical-costs-finder) lets you find out more about the cost of specialist medical services.

Other features of this hospital cover

Covers fund approved hospital-substitution & chronic disease management services. Rates discounted for premiums paid by direct debit.

Extras Cover

This health insurer does not operate a preferred provider scheme.

This policy includes General treatment (Extras) cover for

Treatment & waiting period (months)
Benefit limits per 12 months unless otherwise stated
Examples of maximum benefits
Acupuncture 2

$400 per person up to $800 per policy

combined limit for acupuncture & remedial massage

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Audiology 2

$400 per person up to $800 per policy

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Blood glucose monitors 12

$600 per person up to $1,200 per policy

combined limit for blood glucose monitors, hearing aids & other services

  • Per monitor: 75% of charge
Chiropractic 2

$400 per person up to $800 per policy

combined limit for chiropractic, osteopathy & other services

sub-limits apply

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Dietetics/dietary advice 2

$400 per person up to $800 per policy

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Endodontic 12

$1,000 per person up to $2,000 per policy

combined limit for endodontic & major dental

  • Filling of one root canal: 75% of charge
Exercise physiology 2

$600 per person up to $1,200 per policy

combined limit for exercise physiology, physiotherapy & other services

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Eye therapy (orthoptics) 2

$400 per person up to $800 per policy

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
General dental 2

$1,000 per person up to $2,000 per policy

  • Fluoride treatment: 100% of charge
  • Scale & clean: 100% of charge
  • Periodic oral examination: 100% of charge
Hearing aids 12

$600 per person up to $1,200 per policy

combined limit for blood glucose monitors, hearing aids & other services

  • Hearing aid: 75% of charge
Major dental 12

$1,000 per person up to $2,000 per policy

combined limit for endodontic & major dental

  • Surgical tooth extraction: 75% of charge
  • Full crown veneered: 75% of charge
Non PBS pharmaceuticals* 2

$400 per person up to $40 per service up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

sub-limits apply

  • Per eligible prescription: 100% of charge
Occupational therapy 2

$400 per person up to $800 per policy

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Optical 6

$250 per person

  • Multi-focal lenses & frames: 100% of charge
  • Single vision lenses & frames: 100% of charge
Orthodontic 12

$700 per person

$3,200 lifetime limit

  • Braces for upper & lower teeth, including removal plus fitting of retainer: 75% of charge
Orthotics (podiatric orthoses) 12

$400 per person up to $800 per policy

  • Orthotics supply & fit: 75% of charge
Osteopathy 2

$400 per person up to $800 per policy

combined limit for chiropractic, osteopathy & other services

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Physiotherapy 2

$600 per person up to $1,200 per policy

combined limit for exercise physiology, physiotherapy & other services

sub-limits apply

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Podiatry 2

$400 per person up to $800 per policy

sub-limits apply

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Psychology 2

$400 per person up to $800 per policy

sub-limits apply

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Remedial massage 2

$400 per person up to $800 per policy

combined limit for acupuncture & remedial massage

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Speech therapy 2

$400 per person up to $800 per policy

combined limit for eye therapy (orthoptics) & speech therapy

  • Initial visit: 75% of charge
  • Subsequent visit: 75% of charge
Vaccinations 2

$400 per person up to $40 per service up to $800 per policy

combined limit for non pbs pharmaceuticals & vaccinations

  • Per service: 100% of charge

Acupuncture

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Audiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Blood glucose monitors

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Per monitor: 75% of charge}

Chiropractic

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for chiropractic, osteopathy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Dietetics/dietary advice

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Endodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person up to $2,000 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Filling of one root canal: 75% of charge}

Exercise physiology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for exercise physiology, physiotherapy & other services}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Eye therapy (orthoptics)

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for eye therapy (orthoptics) & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

General dental

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person up to $2,000 per policy}

Examples of maximum benefits

{Fluoride treatment: 100% of charge}

{Scale & clean: 100% of charge}

{Periodic oral examination: 100% of charge}

Hearing aids

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for blood glucose monitors, hearing aids & other services}

Examples of maximum benefits

{Hearing aid: 75% of charge}

Major dental

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$1,000 per person up to $2,000 per policy}

{combined limit for endodontic & major dental}

Examples of maximum benefits

{Surgical tooth extraction: 75% of charge}

{Full crown veneered: 75% of charge}

Non PBS pharmaceuticals*

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $40 per service up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

{sub-limits apply}

Examples of maximum benefits

{Per eligible prescription: 100% of charge}

Occupational therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Optical

Waiting period:  6 months

Benefit limits per 12 months unless otherwise stated

{$250 per person}

Examples of maximum benefits

{Multi-focal lenses & frames: 100% of charge}

{Single vision lenses & frames: 100% of charge}

Orthodontic

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$700 per person}

{$3,200 lifetime limit}

Examples of maximum benefits

{Braces for upper & lower teeth, including removal plus fitting of retainer: 75% of charge}

Orthotics (podiatric orthoses)

Waiting period:  12 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

Examples of maximum benefits

{Orthotics supply & fit: 75% of charge}

Osteopathy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for chiropractic, osteopathy & other services}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Physiotherapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$600 per person up to $1,200 per policy}

{combined limit for exercise physiology, physiotherapy & other services}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Podiatry

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Psychology

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{sub-limits apply}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Remedial massage

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for acupuncture & remedial massage}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Speech therapy

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $800 per policy}

{combined limit for eye therapy (orthoptics) & speech therapy}

Examples of maximum benefits

{Initial visit: 75% of charge}

{Subsequent visit: 75% of charge}

Vaccinations

Waiting period:  2 months

Benefit limits per 12 months unless otherwise stated

{$400 per person up to $40 per service up to $800 per policy}

{combined limit for non pbs pharmaceuticals & vaccinations}

Examples of maximum benefits

{Per service: 100% of charge}

This policy does not include General treatment (Extras) cover for

Ante-natal/Post-natal classes
Chinese medicine
Health management / Healthy lifestyle
Home nursing

Other features of this general treatment cover: 100% back up to $600 per person/$1200 per membership per year for preventative dental, all other dental benefits pay 75% of the cost. Rates discounted for direct debit.

Ambulance cover

In NT this policy provides:

Emergency: Unlimited with no waiting period.

Call-out fees: Will be paid for each attendance, including emergency treatment without transport to hospital.

Other features of this ambulance cover: Benefits for emergency transportations are available on hospital and selected eligible extras covers. To avoid unexpected out of pockets, we strongly recommend taking out a subscription to be covered Australia wide, regardless of your health insurance. If you have eligible extras cover, provide us with the subscription receipt to receive a benefit up to 100% of the subscription cost.

Insurer Details

GMHBA Limited

GMHBA Silver Plus Premium Family Package (No Pregnancy) $500

$738.20 / month

(Before Rebate, Discount & Loading)

Available in NT

Disclaimer: This document is not a Private Health Information Statement (PHIS), and it is not intended to replace that document. The details contained in the healthslips.com.au Policy Information was provided by the insurer to the Australian Government. It is intended as general information. It may not take into account your circumstances. For further information contact the insurer. Information used is Licensed from the Commonwealth of Australia under a Creative Commons 3.0 licence.Private Health Information Statement is available from the Private Health Insurance Ombudsman website at https://privatehealth.gov.au/dynamic/Premium/PHIS/GMH/J72B/DIID20

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